JCL Schuh, PLLC, Bainbridge Island, WA, USA.
Toxicol Pathol. 2021 Apr;49(3):472-482. doi: 10.1177/0192623320970448. Epub 2020 Nov 28.
Mucosa-associated lymphoid tissue (MALT) of special senses is poorly described and can be confused with nonspecific mononuclear cell infiltrates and tertiary lymphoid structures (TLS). In the eye, MALT consists mostly of conjunctiva-associated lymphoid tissue (CALT) and lacrimal drainage-associated lymphoid tissue (LDALT). In humans, CALT and LDALT are important components of the normal eye-associated lymphoid tissue (EALT), but EALT is less frequently described in ocular tissues of animals. The EALT are acquired postnatally in preferential mucosal sites, expand with antigenic exposure, form well-developed lymphoid follicles, and are reported to senesce. Lymphoid follicles that are induced concurrently with chronic inflammation are more appropriately considered TLS but must be differentiated from inflammation in MALT. Less understood is the etiology for formation of lymphoid tissue aggregates in the ciliary body, limbus, or choroid of healthy eyes in animals and humans. In the healthy eustachian tube and middle ear of animals and humans, MALT may be present but is infrequently described. Concurrent with otitis media, lymphoid follicles in the eustachian tube are probably expanded MALT, but lymphoid follicles in the middle ear may be TLS. The purpose of this comparative review is to familiarize toxicologic pathologists with MALT in the special senses and to provide considerations for differentiating and reporting eye and ear MALT from immune or inflammatory cell infiltrates or inflammation in nonclinical studies, and the circumstances for reporting TLS in compartments of the eye and ear.
黏膜相关淋巴组织(MALT)的特殊感觉描述较差,容易与非特异性单核细胞浸润和三级淋巴结构(TLS)混淆。在眼睛中,MALT 主要由结膜相关淋巴组织(CALT)和泪液引流相关淋巴组织(LDALT)组成。在人类中,CALT 和 LDALT 是正常眼相关淋巴组织(EALT)的重要组成部分,但在动物的眼部组织中,EALT 描述较少。EALT 是在出生后获得的,优先在黏膜部位扩张,形成发育良好的淋巴滤泡,并据报道会衰老。与慢性炎症同时诱导的淋巴滤泡更应被视为 TLS,但必须与 MALT 中的炎症区分开来。在动物和人类健康眼睛的睫状体、角膜缘或脉络膜中形成淋巴组织聚集的病因知之甚少。在动物和人类的咽鼓管和中耳中,可能存在 MALT,但很少被描述。在中耳炎同时发生时,咽鼓管中的淋巴滤泡可能是扩张的 MALT,但中耳中的淋巴滤泡可能是 TLS。本综述的目的是使毒理学病理学家熟悉特殊感觉中的 MALT,并为区分和报告非临床研究中眼和耳 MALT 与免疫或炎症细胞浸润或炎症,以及报告眼和耳中 TLS 的情况提供考虑因素。